MALDI-TOF MS contribution to the diagnosis of Campylobacter rectus multiple skull base and brain abscesses

Case presentation of Campylobacter rectus leading to pneumonia and literature review

Pneumonia caused by Campylobacter rectus is very rare. Herein, we describe the treatment course and experiences of a patient with pneumonia caused by Campylobacter rectus. A 64-year-old woman with intermittent hemoptysis and part lung necrosis indicated by radiography was admitted to our hospital on March 15, 2021. After admission, a CT (Computer tomography)-guided percutaneous lung biopsy was identified as Campylobacter rectus positive by bacterial culture and metagenomic sequencing. The hemoptysis resolved, and the lesions in the right lower lung were gradually absorbed after treatment with anti-Campylobacter rectus drugs. In cases of pneumonia which unresolved by initial therapy and associated with more severe oral hygiene problems, the possibility of infection with oral pathogens (eg, Campylobacter rectus) should be considered. This case suggests that bacterial culture and metagenomic sequencing of the diseased tissue, particularly anaerobic culture, helps to clarify the etiological diagnosis.

Fatal case of subdural empyema caused by Campylobacter rectus and Slackia exigua

We report a fatal subdural empyema caused by Campylobacter rectus in a 66-year-old female who developed acute onset of confusion, dysarthria, and paresis in her left extremities. A CT scan showed hypodensity in a crescentic formation with a mild mid-line shift. She had a bruise on her forehead caused by a fall several days before admission, which initially raised subdural hematoma (SDH) diagnosis, and a burr hole procedure was planned. However, her condition deteriorated on the admission night, and she died before dawn. An autopsy revealed that she had subdural empyema (SDE) caused by Campylobacter rectus and Slackia exigua. Both microorganisms are oral microorganisms that rarely cause extra-oral infection. In our case, head trauma caused a skull bone fracture, and sinus infection might have expanded to the subdural space causing SDE. CT/MRI findings were not typical for either SDH or SDE. Early recognition of subdural empyema and prompt initiation of treatment with antibiotics and surgical drainage is essential for cases of SDE. We present our case and a review of four reported cases.

Orbital cellulitis and osteomyelitis secondary to odontogenic infection with campylobacter rectus: a case report

The authors report the first case of orbital osteomyelitis due to Campylobacter in a 50-year-old male on a background of poor dental health. Campylobacter rectus is a member of the human oral flora and is usually associated with periodontal disease. There are 16 reported cases of non-oral C. rectus invasive soft-tissue infections, of which only one reports of osteolytic changes. In our patient, it is hypothesised that contiguous spread of periodontal infection with C. rectus seeded infection to the orbit. C. rectus infection is a rare but significant pathogen that should be considered as the etiologic factor in a patient presenting with an orbital lesion and bony changes, particularly on a background of poor dentition.

Improving the Diagnosis of Bacterial Infections: Evaluation of 16S rRNA Nanopore Metagenomics in Culture-Negative Samples

While 16S rRNA PCR-Sanger sequencing has paved the way for the diagnosis of culture-negative bacterial infections, it does not provide the composition of polymicrobial infections. We aimed to evaluate the performance of the Nanopore-based 16S rRNA metagenomic approach, using both partial and full-length amplification of the gene, and to explore its feasibility and suitability as a routine diagnostic tool for bacterial infections in a clinical laboratory. Thirty-one culture-negative clinical samples from mono- and polymicrobial infections based on Sanger-sequencing results were sequenced on MinION using both the in-house partial amplification and the Nanopore dedicated kit for the full-length amplification of the 16S rRNA gene. Contamination, background noise definition, bacterial identification, and time-effectiveness issues were addressed. Cost optimization was also investigated with the miniaturized version of the flow cell (Flongle). The partial 16S approach had a greater sensitivity compared to the full-length kit that detected bacterial DNA in only 24/31 (77.4%) samples. Setting a threshold of 1% of total reads overcame the background noise issue and eased the interpretation of clinical samples. Results were obtained within 1 day, discriminated polymicrobial samples, and gave accurate bacterial identifications compared to Sanger-based results. We also found that multiplexing and using Flongle flow cells was a cost-effective option. The results confirm that Nanopore technology is user-friendly as well as cost- and time-effective. They also indicate that 16S rRNA targeted metagenomics is a suitable approach to be implemented for the routine diagnosis of culture-negative samples in clinical laboratories.

An Unusual Case of Perirenal Abscess Caused by Campylobacter and Peptostreptococcus Species

Intra-abdominal abscesses mostly derive from the intra-abdominal viscera. Campylobacter spp. are Gram-negative rods which are known to cause oral infections but rarely have been documented to cause extra-intestinal infections resulting in abscesses. We report an atypical case of Campylobacter rectus (C. rectus) and Peptostreptococcus spp. bacteria isolated from a perinephric abscess presenting as abdominal pain. Abscesses originating from outside the gastrointestinal tract have been reported in other similar case reports infecting the head, brain, and thoracic wall amongst others. The potential source and development of such a Campylobacter infection could be due to multiple hypotheses. This is a first case report of perinephric abscess development. Studies have suggested person-to-person (fecal-oral) transmission along with insects serving as primary reservoirs. Seeding of bacteria through infections in the oral cavity or through infections in the bowel microperforations has also been considered as plausible reasons. Since C. rectus has been isolated in such rare instances, it should be kept in mind when considering differential diagnosis of potential causative agents for extra-oral infections such as invasive abscess formations.

Campylob acter r ectus Infection Leads to Lung Abscess: A Case Report and Literature Review

Background

Campylobacter rectus is one of the anaerobic bacteria in the mouth.

Case Presentation

We report the case of a 73-year-old man admitted for lung abscess caused by Campylobacter rectus with unique manifestations under electronic bronchoscopy, and the pathogen is first reported to be confirmed by metagenomic next-generation sequencing (mNGS) through testing bronchoalveolar lavage fluid.

Conclusion

Sometimes, Campylobacter rectus can cause infection outside the mouth such as lung abscess. Most patients have good outcomes.

Multiple Brain Abscesses of Odontogenic Origin. May Oral Microbiota Affect Their Development? A Review of the Current Literature

In the last few years, the role of oral microbiota in the setting of oral diseases such as caries, periodontal disease, oral cancer and systemic infections, including rheumatoid arthritis, cardiovascular disease and brain abscess (BA), has attracted the attention of physicians and researchers. Approximately 5–7% of all BAs have an odontogenic origin, representing an important pathological systemic condition with a high morbidity and mortality. A systematic search of two databases (Pubmed and Ovid EMBASE) was performed for studies published up to 5 January 2021, reporting multiple BAs attributed to an odontogenic origin. According to PRISMA guidelines, we included a total of 16 papers reporting multiple BAs due to odontogenic infections. The aim of this review is to investigate the treatment modality and the clinical outcome of patients with multiple BAs due to odontogenic infections, as well as to identify the most common pathogens involved in this pathological status and their role, in the oral microbiota, in the onset of oral infections. A multidisciplinary approach is essential in the management of multiple BAs. Further studies are required to understand better the role of microbiota in the development of multiple BAs.

First case of Campylobacter rectus and Solobacterium moorei mixed bacteraemia successfully identified by MALDI TOF-MS

Campylobacter rectus and Solobacterium moorei are anaerobic Gram-negative and Gram-positive rods, respectively, that are occasionally members of the human oral flora. Bacteraemia has rarely been reported. We present the first case of mixed C. rectus–S. moorei bacteraemia in an individual with diabetes and human immunodeficiency virus infection. Both bacteria were successfully identified by MALDI-TOF MS.

Mixed anaerobic thoracic empyema: the first report of Filifactor alocis causing extra-oral disease

We report on a case of bilateral lung consolidation and thoracic empyema caused by the periodontal pathogens Filifactor alocis and Campylobacter rectus in a patient with chronic dysphagia. This is the first report of Filifactor alocis causing infection at an extra-oral site.

Clival Osteomyelitis with Cavernous Sinus Thrombosis Due to Fusobacterium nucleatum and Campylobacter rectus Induced by Tooth Extraction

A 70-year-old woman who had suffered from aseptic meningitis complained of chronic headache after dental treatment including tooth extraction. She developed a fever and respiratory failure. Based on chest computed tomography and head magnetic resonance imaging (MRI), she was diagnosed with osteomyelitis in the clivus accompanying moderate pituitary involvement, cavernous sinus thrombosis and septic pulmonary embolism. Both of the causal bacteria, Fusobacterium nucleatum and Campylobacter rectus, were isolated from her blood. Dual infection leading to clival osteomyelitis and cavernous sinus thrombosis has not been reported. It is important to perform enhanced MRI and blood culture for patients with chronic headache related to dental treatment.

Fatal thoracic empyema involving Campylobacter rectus: A case report

We report the case of a 69-year-old man admitted for septic shock secondary to necrotic pneumoniae complicated by thoracic empyema of fatal issue. Microbiological examination of pleural liquid revealed a mixed anaerobic flora involving Campylobacter rectus and Actinomyces meyeri. Campylobacter rectus is an infrequent anaerobic pathogen of oral origin To our knowledge, this is the first case report of fatal C. rectus - associated thoracic empyema, and only the second reported case in which identification was successfully performed by MALDI-TOF MS.